PURPOSE: Ambulatory surgery (same-day or day surgery) is an efficient medical practice. However, there were few reports regarding the safety of ophthalmic ambulatory surgery for children under general anesthesia. This study aims to explore its clinical complications. DESIGN: A retrospective observational study. METHODS: The clinical data of pediatric patients who received ambulatory ophthalmic surgery under general anesthesia at the Children's Hospital of Fudan University from January 2015 to December 2019 were analyzed retrospectively. Postoperative complications, unplanned reoperation, delayed discharge, and other adverse events were analyzed. FINDINGS: Consecutive patients (N = 4,616) had an average age of 4.6 ± 2.6 years. The primary surgical procedures included chalazion incision and curettage (62.89%), strabismus surgery (18.98%), trichiasis surgery (14.36%), eyelid or orbital mass resection (2.49%), blepharoptosis surgery (0.91%), and other procedures (0.37%). The average operative time was 25.28 ± 20.45 minutes (n = 2,698), while the average length of hospital stay was 8.45 ± 2.61 hours. No serious adverse events or death happened. One case had delayed postoperative hemorrhage, one had a postoperative infection, and two had delayed discharge. The rate of unplanned reoperation was 0.39% 90 days after surgery, with recurrence of chalazion and postoperative complications of ptosis as the primary reasons. CONCLUSIONS: Pediatric ophthalmic ambulatory surgery under general anesthesia is a feasible and efficient operation mode with few complications for simple procedures with good general conditions. Further randomized controlled studies are needed to provide strong evidence of the safety and socioeconomic efficacy of this mode.